Epidemiological parameters of COVID-19 and its implication for infectivity among patients in China, 1 January to 11 February 2020

Author:

Lu Qing-Bin12,Zhang Yong31,Liu Ming-Jin4,Zhang Hai-Yang5,Jalali Neda4,Zhang An-Ran54,Li Jia-Chen5,Zhao Han3,Song Qian-Qian3,Zhao Tian-Shuo2,Zhao Jing5,Liu Han-Yu2,Du Juan2,Teng Ai-Ying5,Zhou Zi-Wei5,Zhou Shi-Xia5,Che Tian-Le5,Wang Tao5,Yang Tong5,Guan Xiu-Gang5,Peng Xue-Fang5,Wang Yu-Na5,Zhang Yuan-Yuan5,Lv Shou-Ming5,Liu Bao-Cheng5,Shi Wen-Qiang5,Zhang Xiao-Ai5,Duan Xiao-Gang67,Liu Wei65,Yang Yang64,Fang Li-Qun65

Affiliation:

1. These authors contributed equally to this manuscript

2. Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China

3. School of Mathematical Sciences, Beijing Normal University, Beijing, China

4. Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, United States

5. State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China

6. These senior authors contributed equally to this manuscript

7. School of Statistics, Beijing Normal University, Beijing, China

Abstract

Background The natural history of disease in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remained obscure during the early pandemic. Aim Our objective was to estimate epidemiological parameters of coronavirus disease (COVID-19) and assess the relative infectivity of the incubation period. Methods We estimated the distributions of four epidemiological parameters of SARS-CoV-2 transmission using a large database of COVID-19 cases and potential transmission pairs of cases, and assessed their heterogeneity by demographics, epidemic phase and geographical region. We further calculated the time of peak infectivity and quantified the proportion of secondary infections during the incubation period. Results The median incubation period was 7.2 (95% confidence interval (CI): 6.9‒7.5) days. The median serial and generation intervals were similar, 4.7 (95% CI: 4.2‒5.3) and 4.6 (95% CI: 4.2‒5.1) days, respectively. Paediatric cases < 18 years had a longer incubation period than adult age groups (p = 0.007). The median incubation period increased from 4.4 days before 25 January to 11.5 days after 31 January (p < 0.001), whereas the median serial (generation) interval contracted from 5.9 (4.8) days before 25 January to 3.4 (3.7) days after. The median time from symptom onset to discharge was also shortened from 18.3 before 22 January to 14.1 days after. Peak infectivity occurred 1 day before symptom onset on average, and the incubation period accounted for 70% of transmission. Conclusion The high infectivity during the incubation period led to short generation and serial intervals, necessitating aggressive control measures such as early case finding and quarantine of close contacts.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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